Physician Guidelines and Documentation

The requesting applicant physician must initial that all the required enclosures have been included in the application package for review by the Department.

Waiver Review Application Data Sheet. The Wavier Review Application data sheet must be legible, completed and signed by the physician.

DS 2019 Forms. The request must include copies of all DS 2019 "Certificate of Eligibility for Exchange visitor (J-1) Status for the physician, INS forms 1-94 for the physician and any family members, and proof of passage of examination required by INS.

No Objection Letter. If the J-1 physician medical education/training was funded by the physician's home government, the waiver application request must include a copy of the "no objection" letter from the home government. If there was no funding provided by the J-1 physician's home government, this must be indicated on the Physician Agreement.

Physician Curriculum Vitae and Letters of Recommendation. The request must contain a complete vitae of the physician and three letters of recommendation, within three years prior to submission of application, from medical professionals personally familiar with the physician 's qualifications, work, and personal integrity.

New Jersey Medical License. Physicians must have completed a United States residency in primary care and provide a copy of the applicant 's current New Jersey medical license or proof of New Jersey licensor eligibility. Upon receipt of the license, a copy shall be forwarded to the New Jersey Department of Health prior to forwarding the waiver application to the U.S. Department of State. Copies of all internship, residency and fellowship certificates must be provided, as well as board certification certificates.

Board Certification/Eligibility. Physicians must be board eligible, and become board certified within one year of receiving their waiver. If the physician does not become board eligible within one year of the program, he/she will no longer be eligible to participate.

Specialty. Physicians who have training in family practice and obstetrics/gynecology will receive priority for sponsorship, if the applicant and the organization meet the other criteria. Physicians in general pediatrics and internal medicine are also eligible, however, the need in the area for the services of the specific specialty must be well documented. Physicians with subspecialties or fellowship experience are not considered to be primary care physicians for the purpose of this program, and are generally not eligible for participation. Under exceptional circumstances, e.g. a documented continuous and pervasive lack of access by the indigent population to a specific subspecialty, applications from subspecialists will be considered. Physicians must also be trained in the specialty in which they are practicing.

Employment Contract. The physician must demonstrate a bona fide offer of employment from the health care facility (copy of the complete contract). The contract shall not include a non-compete clause enforceable against the J-1 physician. If the physician obtains a waiver under Public Law 103-416 and thereafter fails to fulfill the terms of his or her employment contract with the health care facility named in the waiver application, he or she becomes subject to the two-year foreign residence requirement, and is ineligible to apply for an nonimmigrant visa, permanent residence, or any other change of nonimmigrant status until the two-year foreign residence requirement is met.

The contract must specify the following:

the physician must agree to work at the health care facility in which he/she is employed for a total of not less than four (4) years;

the physician must practice medicine a minimum of forty (40) hours per week in the geographic area or areas which are designated by the Secretary of Health and Human Services as having a shortage of health care professionals; and,

the physician must agree to begin employment at such facility within ninety (90) days of receiving a waiver.

Affidavit. The physician must provide an affidavit in which he or she avers that their medical license has never been suspended or revoked and that they are not subject to any criminal investigation or proceedings by any medical licensing authority.

Non-Pending Declaration. The J-1 physician must sign and date the statement that avers he or she does not have a pending nor submitting another application request to any United State Government department or agency or any State Department of Public Health or its equivalent during the pendency of this application with the Department of Health.

Relocation. Relocation by the physician from an approved site to a new site must be approved by the New Jersey Department of Health in writing prior to the move.

An original and one unbound copy of the application must be submitted to Linda D. Anderson, Maternal, Child and Community Health Services, New Jersey Department of Health, Division of Family Health Services, 50 E. State Street, PO Box 364, Trenton, NJ 08625-0364. Every item requested in the application and Guidelines should be clearly labeled. J-1 visa waiver applications that do not comply with the required information and documentation, including attachments and enclosures, in its entirety will be returned to the applicant.

This web-based package contains everything necessary to apply to the New Jersey Department of Health for a waiver of home residency requirements. If you have any questions, please contact Linda Anderson at (609) 292-1495.

This program and components of this package are subject to change without notice. The J-1 Visa Waiver/State 30 Program Guidelines are reviewed at least annually. However program changes may occur more frequently as required by federal guidance.

Some health facilities have elected to employ attorneys or qualified consultants to review the waiver package or to assist in the preparation and submission of the required U.S. Immigration and Naturalization Service forms and documentation.